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Saturday, September 20, 2014

The $30 Billion Ice Bucket Challenge

This past summer 3 million
people spontaneously dumped buckets of ice water on their heads and/or donated
their hard earned cash to the ALS Association
to support research. What on earth would
provoke this synchronized advent of charity, without warning? The answer to that question is far beyond the
scope of this blog and lies somewhere wrapped up in the mysteries of human
behavior, perhaps beyond human explanation.
But it certainly had a lot to do with social media.

And it’s a good thing.

Although the origins
of the ice bucket challenge phenomenon are mysterious, the outcome
so far has been an additional $100 million dollars raised to fund efforts to counter Lou Gehrig’s disease
(ALS). Faith in humanity? Restored.

Mysteries aside, I was really excited to see so many people
taking an interest in supporting medical research, and recognizing it as a
valuable cause worthy of uniting us. ALS
is a terrible disease without a cure, and those who are trying to understand it
and treat it need all the help they can get. But, it is only one of many problems that medical researchers are
working on, and incidentally funding for research must be spread around far and
wide.

30 billion dollars is a lot of lettuce – for one person. But for the NIH, this money gets sliced and
diced many ways. At least 237 ways, to
be precise. That is the number of
disease research categories where the money is distributed. You can see the full list here, but these are
the most salient targets of funding:

1.Clinical Research: $10,928,000,000 (10.9
billion)

2.Genetics: $7,330,000,000 (7.3 billion)

3.Prevention: $6,853,000,000 (6.8 billion)

4.Biotechnology: $5,845,000,000 (5.8 billion)

5.Neurosciences: $5,477,000,000 (5.4 billion)

6.Cancer: $5,418,000,000 (5.4 billion)

7.Infectious Diseases: $5,015,000,000 (5.0
billion)

And somewhere much further down the list, you would find Lou
Gehrig’s Disease (ALS), which received a $40,000,000 (40 million) slice of the
pie. Note that many of these categories
overlap, so the sum is well above 30 billion.

The actual ‘research’ is for the most part done by thousands
of grad students and post-docs who are holed up in labs with pipettes away at
universities and research institutes across the country. These are people who work hard, many are passionate about what they do, and most are obviously not in it for the money.

But over the years, federal spending on medical research has not
increased at the same rate as inflation.
This makes it harder and harder to be a research scientist in the United
States.

As a scientist, in order to receive any of this funding in
the form of a grant, you must first write up a long and detailed grant proposal
that explains exactly how much you need, how it will be spent, and how long you
will need it for. After going through a
very competitive review process, only about 17% of the proposals will currently
get the stamp of approval from the NIH. The other 83%
go in the rejected bin.

It was not always so competitive. The success rate was once as high as 45% in
the mid-1970’s, and even 30% at the turn of the millennium. This is illustrated in the chart here below, that I made from data posted on the NIH website.

The Center for American Progress has produced two graphical
illustrations of the decline of NIH funding: one as a percentage of GDP, and one
with values adjusted for inflation. You
can see them here.

Diminishing budget or not, research and development is by
nature not a financially profitable venture.
But perhaps the payoff can be measured in terms of life expectancy rather than dollars. Consider that the average American lifespan from
birth is currently
about 78.5 years, an increase of 8.4 years from 1966 in spite of
the introduction of HIV, the increasing ubiquity of cancer, and the rise of
fast food during the meantime.

In conclusion, the most important thing to understand from
all of this is that medical research is important, it is difficult to do, it is
expensive, it is not usually financially profitable, but it is all for your
benefit. The research that results from
it will hopefully someday find its way back to you down the road when you need
it. It is a tremendous resource to us,
one that perhaps we take for granted too often.

And so next time you file your federal income taxes, feel
free to at least splash a few drops of cold water on your face. Our 30 billion dollar ice bucket challenge
has collectively been accepted.